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Principal Investigator: DEBORAH S HASIN
Organization: NEW YORK STATE PSYCHIATRIC INSTITUTE DBA RESEARCH FOUNDATION FOR MENTAL HYGIENE, INC
Fiscal Year: 2023
Award: $187,206
Funding agency: National Institute on Alcohol Abuse and Alcoholism
Coronavirus Disease 2019 (COVID-19) caused by SARS-CoV-2 is a global pandemic. While most COVID-19
cases are mild or moderate, severe cases (~15%) require hospitalization, critical cases (~5%) require intensive
care, and many deaths occur. Males, Blacks and Hispanics are at greater risk for COVID-19 infection, and poor
prognosis is predicted by older age, race/ethnicity, and prior underlying medical conditions. A potentially critical
factor not yet studied is heavy alcohol use or alcohol use disorder (AU/AUD). AU/AUD could increase the risk
for COVID-19 infection and poor prognosis through poor health behaviors, by direct effects of alcohol on the
immune system, or by indirect effects due to the greater prevalence of underlying medical conditions that predict
poor COVID-19 prognosis. Little is known about the relationship of AU/AUD to the likelihood of COVID-19
vaccination, infection, or poor prognosis, and if these relationships are modified by medical conditions (e.g.,
hypertension, obesity, diabetes), spatially-defined socioenvironmental or exposure variables (e.g., county
poverty or COVID-19 rates) or demographic characteristics (sex, age, race/ethnicity, poverty). To study this,
large databases are needed that include AU/AUD, demographic characteristics, spatial identifiers, diagnostic,
treatment and mortality information. Responding to PA-20-195 (and addressing issues in NOT-AA-20-011), we
will utilize the Veterans Administration (VA) Electronic Medical Record (EMR) system for this purpose. The VA
treats 6.3 million veterans a year. VA patients have high rates of COVID-19 vulnerability factors, e.g., male, older
age, chronic medical conditions. A VA Shared Data Resource identifies COVID-19 cases (now N=186,174, with
9,299 deaths). The many VA patients with ICD-10-CM AUD or positive alcohol (AUDIT-C) screens provide
extensive data on whether the likelihood of COVID-19 outcomes differ by AU/AUD status. Leveraging a research
infrastructure established in an existing project, we propose a 2-year study to comprehensively address the
relationship of AU/AUD to COVID-19 vaccination, infection and prognosis, and how these relationships are
affected by demographic, medical, spatial exposure characteristics. Aim1: Determine the relationship of AU/AUD
to COVID-19 vaccination, infection, and in those infected, poor prognosis (e.g., hospitalization, ICU treatment,
death). Aim 2: Determine if associations of AU/AUD with COVID-19 outcomes vary over time, medical conditions
(e.g., hypertension, obesity, diabetes), spatial exposures or demographic characteristics. In Year 01, we will
analyze EMR diagnostic, treatment, and vital status death data, using a 12-month lookback period to determine
AU/AUD and medical conditions that preceded COVID-19 outcome variables. In Year 02, we will incorporate
National Death Index data to examine causes of death, and expand information on veterans ≥age 65 with
Medicare data. Logistic regression will evaluate differences in COVID-19 outcomes by AU/AUD status. Among
those with COVID-19, survival models will determine if time to poor prognosis events differs by AU/AUD. Results
will fill major gaps in knowledge about the risks for and prognosis of COVID-19 among those with AU/AUD.
Terms: <2019 novel corona virus><2019 novel coronavirus><2019-nCoV><65+ years old><ARDS><Acute Respiratory Distress><Acute Respiratory Distress Syndrome><Address><Adult ARDS><Adult RDS><Adult Respiratory Distress Syndrome><Affect><Age><Aged 65 and Over><Alcohol Chemical Class><Alcohol Drinking><Alcohol consumption><Alcohols><Back><Behavioral><Big Data><BigData><Biological><Black><Black Populations><Black group><Black individual><Black people><Black race><Blacks><COVID disease severity><COVID severity><COVID-19><COVID-19 disease severity><COVID-19 exposure><COVID-19 infection><COVID-19 negative><COVID-19 predisposition><COVID-19 prognosis><COVID-19 related risk><COVID-19 risk><COVID-19 risk factor><COVID-19 severity><COVID-19 susceptibility><COVID-19 vaccination><COVID-19 virus><COVID-19 virus infection><COVID-19 vulnerability><COVID19><COVID19 disease severity><COVID19 infection><COVID19 negative><COVID19 prognosis><COVID19 severity><COVID19 vaccination><COVID19 virus><CV-19><CV19><Caring><Cause of Death><Cessation of life><Characteristics><Chronic><CoV emergence><CoV-2><CoV2><Computerized Medical Record><Coronavirus disease 2019 predisposition><Coronavirus disease 2019 susceptibility><Coronavirus disease 2019 vulnerability><County><Da Nang Lung><Data><Data Banks><Data Bases><Databanks><Databases><Death><Diabetes Mellitus><Diagnosis><Diagnostic><Disasters><Disease><Disorder><Dorsum><EMR system><Electronic Medical Record><EtOH drinking><EtOH use><Ethnic Origin><Ethnicity><Event><Exploratory/Developmental Grant><Funding><Future><General Population><General Public><Health><Health Insurance for Aged and Disabled, Title 18><Health Insurance for Disabled Title 18><Health behavior><Heavy Drinking><Hispanic><Hispanic Populations><Hispanic group><Hispanic individual><Hispanic people><Hispanics><Hospital Admission><Hospitalization><Hypertension><ICD-10-CM><Immune response><Immune system><Immunological response><Impairment><Impoverished><Individual><Infection><Intensive Care><Knowledge><Link><Logistic Regressions><Medical><Medicare><Minority><Misinformation><Modeling><NIAAA><National Institute on Alcohol Abuse and Alcoholism><Obesity><Outcome><Patients><Persons><Pneumonia><Policies><Poverty><Predisposed to COVID-19><Predisposed to SARS-CoV-2><Predisposed to Severe acute respiratory syndrome coronavirus 2><Prevalence><Preventive><Process><Prognosis><Provider><R21 Mechanism><R21 Program><Race><Races><Research Infrastructure><Retrospective cohort><Risk><SARS corona virus 2><SARS-CO-V2><SARS-COVID-2><SARS-CoV-2><SARS-CoV-2 disease severity><SARS-CoV-2 exposure><SARS-CoV-2 infection><SARS-CoV-2 negative><SARS-CoV-2 predisposition><SARS-CoV-2 prognosis><SARS-CoV-2 severity><SARS-CoV-2 susceptibility><SARS-CoV-2 vaccination><SARS-CoV-2 vulnerability><SARS-CoV2><SARS-CoV2 exposure><SARS-CoV2 infection><SARS-associated corona virus 2><SARS-associated coronavirus 2><SARS-coronavirus-2><SARS-related corona virus 2><SARS-related coronavirus 2><SARSCoV2><Scientist><Services><Severe Acute Respiratory Coronavirus 2><Severe Acute Respiratory Distress Syndrome CoV 2><Severe Acute Respiratory Distress Syndrome Corona Virus 2><Severe Acute Respiratory Distress Syndrome Coronavirus 2><Severe Acute Respiratory Syndrome CoV 2><Severe Acute Respiratory Syndrome-associated coronavirus 2><Severe Acute Respiratory Syndrome-related coronavirus 2><Severe acute respiratory syndrome associated corona virus 2><Severe acute respiratory syndrome coronavirus 2><Severe acute respiratory syndrome coronavirus 2 exposure><Severe acute respiratory syndrome coronavirus 2 infection><Severe acute respiratory syndrome coronavirus 2 predisposition><Severe acute respiratory syndrome coronavirus 2 susceptibility><Severe acute respiratory syndrome coronavirus 2 vaccination><Severe acute respiratory syndrome coronavirus 2 vulnerability><Severe acute respiratory syndrome related corona virus 2><Shock Lung><Social Environment><Statistical Data Analyses><Statistical Data Analysis><Statistical Data Interpretation><Stiff lung><Stress><Testing><Time><Title 18><United States Department of Veterans Affairs><United States Veterans Administration><Vaccinated><Vaccination><Vaccines><Vascular Hypertensive Disease><Vascular Hypertensive Disorder><Veterans><Veterans Administration><Veterans Affairs><Viral Diseases><Virus Diseases><Vital Status><Wuhan coronavirus><adiposity><age 65 and greater><age 65 and older><aged 65 and greater><aged ≥65><ages><alcohol effect><alcohol ingestion><alcohol intake><alcohol product use><alcohol screening><alcohol use><alcohol use disorder><alcoholic beverage consumption><alcoholic drink intake><biologic><coping><corona virus disease 2019><corona virus emergence><coronavirus disease 2019><coronavirus disease 2019 disease severity><coronavirus disease 2019 exposure><coronavirus disease 2019 infection><coronavirus disease 2019 negative><coronavirus disease 2019 prognosis><coronavirus disease 2019 risk><coronavirus disease 2019 risk factor><coronavirus disease 2019 severity><coronavirus disease 2019 vaccination><coronavirus disease 2019 virus><coronavirus disease severity><coronavirus disease-19><coronavirus disease-19 virus><coronavirus emergence><coronavirus infectious disease-19><corpulence><cost><data base><data depository><data repository><data resource><data set repository><data sharing><data sharing networks><data sharing resource><dataset repository><demographics><deploy vaccines><design><designing><diabetes><distribute vaccines><drink heavily><drinking><electronic medical record system><electronic medical system><emergent CoV><emergent corona virus><emergent coronavirus><emerging CoV><emerging corona virus><emerging coronavirus><ethanol consumption><ethanol drinking><ethanol effect><ethanol ingestion><ethanol intake><ethanol product use><ethanol use><ethanol use disorder><excessive alcohol consumption><excessive alcohol ingestion><excessive alcohol intake><excessive drinking><excessive ethanol ingestion><exploratory developmental study><exposure to COVID-19><exposure to SARS-CoV-2><exposure to SARS-CoV2><exposure to Severe acute respiratory syndrome coronavirus 2><exposure to coronavirus disease 2019><extreme drinking><hCoV19><health insurance for disabled><health related behavior><heavy alcohol use><hesitant to vaccination><high blood pressure><host response><housing instability><human old age (65+)><hyperpiesia><hyperpiesis><hypertensive disease><hypertensive disorder><immune system response><immunoresponse><indexing><infected with COVID-19><infected with COVID19><infected with SARS-CoV-2><infected with SARS-CoV2><infected with coronavirus disease 2019><infected with severe acute respiratory syndrome coronavirus 2><infection risk><instably housed><interest><male><men><mortality><nCoV><nCoV2><new CoV><new corona virus><new coronavirus><novel CoV><novel corona virus><novel coronavirus><old age><pandemic><pandemic disease><predisposed to Coronavirus disease 2019><prognosis in COVID-19><prognosis in COVID19><prognosis in SARS-COV-2><prognosis in coronavirus disease 2019><racial><racial background><racial origin><residence><residential building><residential site><risk associated with COVID-19><risk factor associated with COVID-19><risk factor related to COVID-19><risk related to COVID-19><service providers><severe acute respiratory syndrome coronavirus 2 disease severity><severe acute respiratory syndrome coronavirus 2 negative><severe acute respiratory syndrome coronavirus 2 prognosis><severe acute respiratory syndrome coronavirus 2 severity><sex><social climate><social context><socio-demographics><sociodemographics><socioenvironment><socioenvironmental><statistical analysis><susceptible to COVID-19><susceptible to Coronavirus disease 2019><susceptible to SARS-CoV-2><susceptible to Severe acute respiratory syndrome coronavirus 2><unstable housing><unstably housed><vaccinate against COVID-19><vaccinate against COVID19><vaccinate against SARS-CoV-2><vaccinate against coronavirus disease 2019><vaccinate against severe acute respiratory syndrome coronavirus 2><vaccination against COVID-19><vaccination against COVID19><vaccination against SARS-CoV-2><vaccination against Severe acute respiratory syndrome coronavirus 2><vaccination against coronavirus disease 2019><vaccination hesitancy><vaccine deployment><vaccine distribution><vaccine hesitancy><vaccine hesitant><vaccine roll-out><vaccine rollout><viral infection><virus infection><virus-induced disease><wet lung>